The kitchen counter in the home of the Hayes family is scattered with the inhalers, sprays and bottles of pills that have allowed Hannah, 13, and her sister, Abby, 10, to excel at dance and gymnastics despite a pollen season that has set off asthma attacks.

Asthma — the most common medical condition that affects Americans of all ages, about 40 million people — can usually be well controlled with drugs. But being able to afford prescription medications in the United States often requires top-notch insurance or plenty of disposable income, and time to hunt for deals and bargains.

The arsenal of medicines at the Hayeses' helps explain why. Pulmicort, a steroid inhaler, retails for more than $175 in the United States, while pharmacists in Britain buy the identical product for about $20 and dispense it free of charge to patients. Albuterol, one of the oldest asthma medicines, typically costs $50 to $100 per inhaler in the United States, but it was less than $15 a decade ago, before it was repatented.

"The one that really blew my mind was the nasal spray," said Robin Levi, Hannah and Abby's mother, referring to her $80 co-payment for Rhinocort Aqua, a prescription drug that was selling for more than $250 a month last year but costs less than $7 in Europe.

The Centers for Disease Control and Prevention puts the annual U.S. cost of asthma at more than $56 billion, including millions of potentially avoidable hospital visits and more than 3,300 deaths. The United States spends far more per capita on medicines than other developed countries. Drugs account for 10 percent of the country's $2.7 trillion annual health bill, even though the average American takes fewer medicines than people in France or Canada, said Gerard Anderson of the Bloomberg School of Public Health at Johns Hopkins University. And prescription drug spending is expected to rise sharply as the economy recovers and as millions of Americans become insured under the Affordable Care Act, said Murray Aitken, the executive director of IMS Health.

statins may curb gum disease

Statins may have a beneficial side effect: reducing gum inflammation, or periodontitis. Almost half of U.S. adults have periodontitis, and it is a known risk factor for atherosclerosis, the buildup of plaque in the arteries. In a randomized trial, researchers assigned 83 people with heart disease or at high risk for heart disease to take a daily dose of either 80 milligrams or 10 milligrams of atorvastatin (Lipitor and generics) for 12 weeks. There was a reduction in gum inflammation in the group that took the 80-milligram dose compared with those who took the lower dose. The differences were greatest in those with the most severe gum disease. "It's surprising," said the senior author, Dr. Ahmed Tawakol of Harvard.

Yoga for menopause? Many women seek alternatives to hormone replacement therapy to treat menopause symptoms. Some have turned to yoga, but its a trial shows that its benefits may be limited. Compared with the usual activity group, the yoga group had improvements with insomnia. But there were no statistically significant improvements in depression or perceived severity of hot flashes.